Effects of Transcutaneous Electrical Nerve Stimulation in Autonomic Nervous System of Hypertensive Patients: A Randomized Controlled Trial

Curr Hypertens Rev. 2018;14(1):66-71. doi: 10.2174/1573402114666180416155528.


Background: Patients with hypertension have altered autonomic nervous system function, which are increased sympathetic activity. Transcutaneous Electrical Nerve Stimulation (TENS) is a useful modality for pain control and has also been shown to be effective in the reduction of sympathetic activity in healthy subjects and individuals with cardiovascular diseases.

Objective: The aim of this study was to verify the effects of transcutaneous electrical nerve stimulation by the evaluation of heart rate variability (HRV) in patients with essential hypertension.

Method: Twenty-eight patients received an application of low-frequency TENS(4 Hz) n=8, highfrequency TENS (100 Hz) n=10 or placebo TENS n=10 in paravertebral ganglionar region during thirty minutes.

Results: After 4 Hz TENS, there was a decrease in the low-frequency (LFn.u.) component (57.71±9.46 vs 45.58±13.51, p<0.026) and an increase in the high-frequency (HFn.u.) component (33.03±13.83 vs 45.83±20.19, p <0.05) of HRV. After 100 Hz TENS and placebo, there were no changes in the LF and HF components. No significant differences were found in systolic blood pressure with low-frequency TENS (129.37± 15.48 vs 126.69 ± 15.21, p<0.490). There was an increase, although not significant, with high-frequency TENS (131.00 ± 15.97 vs 138.75 ± 25.79, p<0.121) and placebo (133.80 ± 29.85 vs 134.80 ± 29.72, p< 0.800). No differences were found in the diastolic blood pressure with low-frequency TENS and placebo, but there was a significant increase in high-frequency TENS (81.00 ± 11.78 vs 85.65 ± 13.68, p< 0.018).

Conclusion: Low-frequency TENS decreases sympathetic nervous system activity and increases parasympathetic nervous system activity and high-frequency TENS increases diastolic blood pressure, when applied on the paravertebral ganglionar region in the hypertensive patients.

Keywords: Hypertension; autonomic nervous system; heart rate variability; parasympathetic nervous system; sympathetic nervous system; transcutaneous electrical nerve stimulation..

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Arterial Pressure*
  • Autonomic Nervous System / physiopathology*
  • Brazil
  • Cardiovascular System / innervation*
  • Double-Blind Method
  • Essential Hypertension / diagnosis
  • Essential Hypertension / physiopathology
  • Essential Hypertension / therapy*
  • Female
  • Ganglia, Autonomic / physiopathology
  • Heart Rate*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Time Factors
  • Transcutaneous Electric Nerve Stimulation* / adverse effects
  • Treatment Outcome